Glioblastoma (GBM): Understanding Your Treatment Options
A frank, compassionate guide to glioblastoma multiforme — what it is, current treatment protocols (Stupp Protocol), prognosis, clinical trials, and quality of life.
· Updated 11 March 2025
Glioblastoma (GBM): Understanding Your Treatment Options
Glioblastoma (GBM) is the most aggressive primary brain tumour. This guide explains what it is, how it is treated, and what to expect — honestly and clearly.
What Is GBM?
GBM is a WHO Grade IV brain tumour that grows within brain tissue itself. Tumour cells infiltrate surrounding brain along microscopic paths — which is why surgery alone cannot cure it.
It mainly affects adults in their 60s–70s, accounting for roughly 15% of primary brain tumours.
Symptoms
- New seizures, progressive weakness, or speech difficulty
- Morning headaches with nausea
- Personality or cognitive changes
Symptoms developing over weeks — not years — are more concerning.
Diagnosis
MRI with contrast shows a ring-enhancing mass with central necrosis. Surgery or biopsy provides tissue for diagnosis and molecular testing.
Key molecular markers:
- IDH status — IDH-wildtype GBM is the most aggressive form
- MGMT methylation — present in ~40% of GBMs; predicts better response to chemotherapy
The Stupp Protocol (Standard Treatment)
- Surgery — maximal safe resection using intraoperative MRI, 5-ALA fluorescence, and neuromonitoring. Awake craniotomy for tumours near speech or motor areas.
- Concurrent radiotherapy + temozolomide — 6 weeks of daily radiation with chemotherapy.
- Adjuvant temozolomide — 6 months of chemotherapy cycles.
Additional Options
- Bevacizumab — reduces tumour swelling; used in recurrent GBM
- TTFields (Optune) — wearable device that disrupts cell division; improves survival when added to treatment
- Clinical trials — discussed with all eligible patients
Prognosis
Median survival with treatment is 14–16 months. MGMT methylation, age, and extent of resection all influence individual outcomes. Population statistics do not define what is possible for an individual.
Care Philosophy
Treatment aims to extend life and protect its quality. Palliative care is involved early as a partner — not a last resort.
Contact KPJ Tawakkal to arrange a consultation. Timing matters.